Self-Reported Performance and Hormonal-Cycle-Related Symptoms in Competitive Female Athletes

Introduction: The present scientific fi c consensus is that the menstrual cycle (MC) and hormonal contraceptive (HC) cycle only influence performance trivially. Nevertheless, athletes perceive changes in performance that they associate with different phases of their hormonal cycle. Methods: A total of 959 female athletes completed a questionnaire, of which 750 were included in the present analysis. The questionnaire included questions about demographics and experiences of the MC and HC (symptoms, perceived impact on performance characteristics). Results: In total, 55% of athletes reported a natural MC while 45% reported HC use. Meanwhile, 56% of all athletes reported a decline in perceived performance during the bleeding or inactive phase, whereas 26% of all athletes reported no changes in performance over their hormonal cycle. All athletes reported an average of 10 +/- 7 symptoms during hormonal cycles. The naturally menstruating (NM) group reported more symptoms than the HC group (p < .05). The most frequent symptoms reported were abdominal pain, bloating, and mood swings. Only 7% of all athletes (4.1% in NM and 11.3% in HC) reported an absence of any symptoms. Quantity of total symptoms was associated with a perceived decrease in performance (R-2 = .138, p < .05). Hormonal cycles had the greatest negative effect on mental performance with 37% reporting a large to very large effect. Conclusions: Perceived negative effects on performance were similar in both NM and HC groups while perceived mental performance (e.g., mood and attention) appeared to be most affected by both MC and HC.